Fracture frame



l Dec. 29, 1942. VHLM. BERGAMINI' v A2,306,929

- FRACTURE FRAME Filed Aug. 29, 1941 5 Sheets-Sheet 1 Dea-29, 1942. I H.M. BRGAMINI FRACTURE FRAME 5 Sheets-Sheet 2 Filed Aug. 29, 1941 Dec. 29,1.942- H. M. BERGAMINI FRACTURE FRAME Filed Aug. 29, 1941 5 Sheets-Sheet3 Dec. 29, 1942. H. M. BERGAMINI A 2,306,929

FRAGTURE FRAME Filed Aug. 29. 1941 5 Sheets-Sheet 4 Dec. 29, 1942.

H. M. BERGAMINI 2,306,929

FRACTURB FRAME Filed Aug. 29, 1941 5 Sheets-Sheet 5 Patented Dec. 29,1942 UNITED STATES PATENT. OFFICE 2,306,929 y FRACTUREFRAME Herbert M.Bergamini, New York, N. Y. Application August 29, 1941, Serial No.408,877

Claims.

This invention relates to orthopedic surgery, and more particularly ithas reference to a fracture frame or supporting structure wherein thepatient is supported from above, thus eliminating the necessity oflifting the patient bodily from a stretcher onto a fracture table and atthe same time affording sufficient freedom from obstruction to permitX-ray and fluoroscopic examination of the injured parts from all desiredangles.

An object of the inventio-n is to provide a fracture frame that willpermit correct manipulation and setting of fractures of either the upperor lower extremities.

Another object is to provide a fracture frame having the patientsupporting means and the extremity supporting members suspended from theframe.

A further object is to provide a fracture frame having suspended patientsupporting means and extremity supporting members with means whereby thevertical position of the patient supporting means can be varied and theangular, longitudinal and vertical positions of the extremity supportingmembers with respect to the patient supporting means can be adjusted.

And a further object is to provide a frame of the type herein describedwith means whereby the extremity supporting members may be suspendedfrom the frame and having the extremity supporting members mounted foruniversal movement on the suspending means.

An additional object of the present invention is to provide a fractureframe wherein the extremity supporting members are suspended from theframe thereby preventing displacement of the foot piece caused by theweight of the injured part.

Still a further object is to provide a fracture frame with a patientsupporting member that is suspended from the frame and verticallyadjustable with respect to the frame which carries at its free end agallows for treating patients with broken backs.

Yet another object of the present invention is to provide a fractureframe with means to support a sling or hammock to enable the treatmentof broken backs and provided with further means to adjust the positionof the sling or hammock Still a further object is to provide a mobilefracture frame that is pleasing in appearance including a few principalworking parts and capable of being manufactured cheaply.I

To achieve the above and other objects, the

invention embraces broadly a mobile frame comprising upright membersinterconnected by means of longitudinal members. Suspended from thelongitudinal members and movable vertically in relation thereto is apatient supporting rest. Likewise suspended from the frame are aplurality of supports each of which may be adjusted with respect to thepatient supporting rest. Mounted to each supporting member for universalmovement is an extremity supporting member, thereby permitting any typeof fracture to be taken care of. The supporting members, in addition tohaving angular movement have longitudinal and vertical movement wherebythe extremity supporting member may bevmoved closer toward or fartheraway from the patient supporting rest to accommodate various leg or armlengths and various methods of ltreating the injured parts.

A hammock for the treatment of patients with broken backs may beassociated with the upright members and means are provided whereby thearc of the hammock may be varied to compensate for the particular typeof injury. In addition, a gallows is connected to the upper end of thepatient supporting member for the treatment of broken backs. i

In the drawings, in which like numerals Vindicate the same or similarparts:

Figure 1 is a view in perspective of my novel fracture frame;

u Figure 2 is a sectional view taken along line 2-2 of Figure 1 lookingin the direction of the arrows;

Figure 3 is a view in perspective of one of the members for suspendingthe extremity supporting member from the frame;

Figure 4 is a diagrammatic representation of the gearing for elevatingor lowering the sacral seat; Figure 5 is a fragmental transversesectional view of the frame showing perineal bar and sacral seatattached thereto, the extremity supporting member together with itssuspension means and showing in broken lines the extremity supportingmember in an adjusted position with respect to the sacral seat;

Figure 6 is a detailed transverse sectional View Vof the extremitysupporting member;

hammock supported by the uprights for the treatment of a patient with abroken back;

Figure l is a fragmental View illustrating the mode of attachment of theextremity of the hammock to the uprights and showing the means wherebythe arc of the hammock may be adjusted;

Figure 1l is a sectional view taken along the line I I--I I of FigureFigure 12 is a view in perspective illustrating in detail the meanswhereby the hammock may be adjusted;

Figure 13 is a View in end elevation illustrating the gallovvs inoperative position for the treatment of a patient with a broken back;

Figure 14 is a view in perspective of the galloWs shown in Figure 13;

Figure l5 is a vieW in perspective illustrating an attachment to beconnected to the uprights and sacral seat for the treatment of fractureof the upper extremities;

Figure 16 is a view in perspective of the sacral seat.

My novel fracture frame comprising uprights Iinterconnected at theirupper ends by means ure 1, that when the leg portion 4 is in the yposition shown in the full lines a very firm supporting position for theframe is provided, and there can be no danger of the frame tipping overduring an operation. By manipulation of the locking device 5, each legportion 4 may be moved to the position shown in the broken lines therebyenabling the frame to be readily wheeled through doors, etc., thusaording a highly mobile unit.

A transverse tube 6 is attached to each upright I as illustrated inFigure l, and the function of this member Will hereinafter be more fullyelaborated upon.

Detachably secured to the lower side of the longitudinally extendingmembers 3 and disposed intermediate the cross members 2 is a gear box 1.Extending vertically through the gear box 1 is a perineal bar 8, at thelower end of which is supported a sacral seat 9 to be used for intantsor small children and a larger sacral seat I0 for adults. The seat I0may be moved along the bar 8 and is adapted to be engaged by a springclip II attached to the box 1, for maintaining the seat ID out of theway when an operation is being performed on an infant. It should bementioned, however, that under normal conditions the seat I0 rests uponthe seat 9 as shown in Figure 5.

As hereinbefore mentioned, an important feature of this invention isthat the patient is supported from above and consequently means areprovided whereby the height of the sacral seat I0 may be adjusted. Toeffect such adjustment, it will be noted that the bar 8 has suitablysecured thereto a rack I2. A pinion I3 meshes with the rack I2 and isconnected to shaft I4 that is also provided with a worm wheel I5. Theworm Wheel I5 in turn meshes with a worm IB carried by one end `of ashaft I'I that eX- Vtends through and -s suitably journalled in one ofthe longitudinal members 3, as best shown in Figure 2. The opposite endof the shaft I'l carries a sprocket I8 positioned within the cross beam2. A second sprocket I9 is laterally spaced from the sprocket I8 and isattached to a short shaft also journalled in the beam 2, and a chain 20is trained around the sprockets I8 and I 9. Carried by the shaft whichsupports the sprocket I9 and spaced therefrom is another sprocket 2I. Ahollow vertical support member 22 has its upper end in communicationwith the beam 2 and its lower end attached to the transverse tube 6.Journalled in the member 22 is a shaft 23 which carries a sprocket 23within the member 22. A second chain 24 is trained around the sprockets2l and 23. Fixed to the outer end of the shaft 23 is a hand wheel 25. Itis apparent that by rotation of the hand wheel 25, vertical movement ofthe perineal bar 8 is effected.

From the above, it will be noted that I have provided a very simplestructure for adjusting the vertical position of the sacral seat I0 andall working parts are enclosed Within the frame or its associatedelements.

Another particularly advantageous feature of this frame is thatextremity supporting members or stirrups designated generally 2B aresuspended from the frame. Attention is now directed to Figure 5, whereinit will be noted that suspension means 21 for the stirrups 26 islikewise supported by the gear box 1. More specifically, each member 2'Icomprises a hollow tubular member 28 having an eye 29 at its inner endand being mounted for pivotal movement to the gear boX by means of asuitable bolt construction 30. Telescoped Within the tube 28 is atubular member 32 which is substantially L-shaped, and a collar 33having a locking device 34 is utilized to secure the member 32 withrespect to the tubular member 28. As perhaps best shown in Figure 5, thelongitudinal and vertical positions of the stirrups 26 can be variedwith respect to the sacral seat ID to accommodate various leg or armlengths as will hereinafter be more fully discussed. When the properposition of the tubular member 32 in relation to the seat is determined,manipulation of the locking device 34 will maintain the member 32 in thecorrect longitudinal position.

A red 35 projects Within the depending end of the L-shaped tube 32 and acollar 3e is provided on the lower end of the tube 32. A locking member3'! is associated with the collar 36 to lock the rod 35 with the tube32. By unloosening the member 3l it is thought apparent that thevertical position of the rod 35 with respect to the sacral seat may bechanged. rIhe lower end cf the red 35 is securely Fitted within a socket38 formed in a support member 39. The lower end -of the support 39 isreduced as shown at 43, and the reduced end 43 fits within a bifurcation4I formed in a. sleeve 42. A bolt 43 extends through aligned aperturesin the sleeve 42 and in the reduced portion 4I. for mounting the sleeve42 for pivotal movement about a horizontal axis on the support 33. Awing nut 44 is threaded onto the free end of the bolt 43 tc lock thesleeve 42 in the desired angular position. I

Slidably mounted in the sleeve i2 is an adjusting screw 46. The screwhas a key-way 4l into which ts a key 43 to prevent rotative displacementof the screw. One end of the screw is threaded into a base 49 to whichis removably attached a foot receiving portion 55. As best shown inFigure 8, a winged lock nut 5I sur- -ro'unds the screw 46 adjacent tothe base 49 whereby angular adjustment of the foot receiving portion 50with respect to the screw may be effected. Threaded onto the screw 46 isanother wing nut 52, the rotation of which effects linear movement ofthe stirrup 26 to cause extension of the broken extremity.

It is thought clear that each extremity supporting member, by havinguniversal adjustment, various types of procedure in the treatment offractured extremities may be easily accomplished.

As mentioned before one of the most important objects of the inventionis tc provide means whereby the angular position of the extremitysupporting means 26 in regard to the sacral seat I6 can be varied. As aconsequence, it is necessary to provide a structure whereby the angular'adjusted position of the extremity supporting member will be maintainedas it is most undesirable to have any shifting, so to speak, of theextremity supporting member during the operation. To accomplish thisend, it will be noted that a radius rod 511 is pivoted at one end to thegear box 1 by a bolt 55. radius rod is attached to a collar 56 whichsurrounds the tubular member 26 at a point adjacent to the collar 33. Alocking screw 51 is threaded into an aperture in the collar 56 as shownin Figure 3. When the desired angular position has been determined, andthe tubular member 26 is moved thereto the screw 51 is rotated to lockthe collar 56 which, of course, locks the radius rod thus preventing anymovement of the tube 28 about its pivot point 36.

While I have described but one of the extremity supporting members 26and its associated suspending means, it is to be understood that eachmember is identical in construction and operation.

When it is desired to use my frame for -fractures or dislocations of theleg, the patient is rolled under the frame on a stretcher cart. A sacralseat i6 is then lowered by rotating the hand wheel until the seat is ina position to support the patient at his hips. The member 32 is thenadjusted to the length of the leg and the foot is taped to the footreceiving portion 50. The entire suspension means for the extremitysupporting member 26 may be adjusted to take I care of the particularfracture or dislocation encountered. The stretcher cart may then beremoved from beneath the patient and rolled back to a position whichwill enable the patient to rest his head and shoulders on the cart.

The foot receiving portion is then moved away from the perineal bar 8 byrotation of the winged nut 52 to permit replacement of the overlappedfracture. After the fracture has been correctly aligned the cast, etc.is then applied. It can be seen that there is no obstruction between theperineal bar and the foot receiving portion 56 which makes it mucheasier to perform the operation.

In the event X-ray or luoroscopic examination is desirable there issuflicient area beneath the patient to enable an examination from allangles.

After the operation is completed the stretcher cart is then wheeled intoposition to support the full length of the patient and the footreceiving portion 50 is removed from the foot. The sacral seat is thenremoved by rotation of the hand wheel.

With my novel fracture frame it is obvious that there is no necessityfor lifting the patient from The opposite end of the the stretcher ontothe fracture table to perform the operation or is it necessary when theoperation is completed to remove the patient from a table onto thestretcher cart. The advantages of this procedure are thought to beobvious.

The frame is also capable of being converted for operations pertainingto back fractures or injuries and in Figures 9 to 12 inclusive, I haveshown the structure for accomplishing this purpose. When the frame is tobe used for this type of operation, it is necessary that the sacral seatfirst be elevated until it is completely out of the way and this isreadily done by rotation of vthe hand wheel 25.

It Will be noted that the inner face of each transverse tube 6 is formedwith an arcuate surface 60. A bar 6l fits within the arcuate surface andis maintained therein by bolts 62 which extend through aperturesprovided in the hollow tube 6 and locked by means of wing nuts 63. Oneend of the hammock 64 is disposed between one tube 6 and its bar 6I asshown in Figure 10, and the wing nut 63 is 'then rotated to draw the bar6| tightly against the arcuate surface 66 to secure this end of thehammock to the transverse tube 6.

Attached to the tube 6 on the opposite pair of uprights are a pair ofhollow spaced vertical members 65 (see Figure l). A shaft 66 having alongitudinal slot 61 is rotatably journalled in bearings 68 carried bythe vertical members 65. The shaft has keyed to one end thereof, a wormwheel 66 which meshes with a worm 16 formed on a shaft 1|. A hand Wheel12 is secured t0 the shaft 1l so that the worm gearing may be rotated. y

The other end of the hammock 64 is guided between the opposite tube 6and its bar 6| and the free end is inserted through the slot 61 to holdthis end of the hammock against slipping. The hand wheel 12 is thenrotated and the position of the hammock can be adjusted to take care ofthe type of back injury in question.

'I'he worm gearing is irreversible and this is particularly efficaciousin that it will prevent any slipping of the hammock from its properlyvadjusted position.

In the use of this particular embodiment, the hammock is preferablyplaced on the stretcher cart before the patient has been positionedthereon, although this is not absolutely necessary. The cart is thenwheeled under the operating frame and the ends of the hammock aresecured in the manner previously mentioned. By rotating the hand wheel12, the hammock may be adjusted to the proper position. The cart is thenmoved away from beneath the hammock and the patient is ready for thenecessary operation.

In Figures 13 and 14, I have shown an attachment, that is incorporatedYwith the perineal bar 8 for the treatment of back injuries. Asubstantially L-shaped bracket or gallows 15 is fitted within the upperopen end of the perineal bar 8. The upper end of the tube is providedwith a pair of angularly disposed slots 16. A pin 11 carried by thevertical portion of the bracket is adapted to fit into the slots. Byelevating the bracket to withdraw the pin from the slot, it is possibleto swing the bracket from its stowed position parallel with the frame tothe position shown in Figure 13, wherein it projects a slight distancebeyond the top edge of the frame.

The end of the bracket is provided with a hook 18 which carries a ring80. A harness indicated 19' for .fitting around the patients head isadapted to be attached to the ring 'I9 as shown in Figure 13. BySupporting the patient in the manner shown, it is possible for theattendant to set or otherwise treat the injured back.

By rotating the hand wheel 25, the position of the gallows 'l5 withrespect to the oor may be elevated or lowered.

While the above description with reference to the extremity supportingmembers is directed to the working on the lower extremities, attentionis directed to Figures 15 and 16, wherein I have shown means foremploying my inventive concept for operating on the upper extremities.

I also provide for use with the frame a back and head supportingstructure shown in Figure 15. This comprises a substantially U-shapedbracket 80 which carries at its upper end a pair of tubular extensions8i which are offset from the bracket. The extensions 8l extend throughopenings 82 provided in the transverse tube 6, and screws 83 areprovided to lock the bracket in the correct position. rI'he horizontalportion of the bracket 8i] is formed with a slide 84, and a bar 35 whichcarries a back support plate and a head supporting member 8l is adaptedto have one o f its ends extend through the slide. The opposite end ofthe bar 85 fits into a grooved recess 88 formed in the upper portion ofthe sacral seat ill. As a consequence, the bar is rigidly supported bythe frame.

The plate Bt and the member 8l are movable longitudinally along the bar85 to accommodate the body proportions of the particular patient, andmeans are provided to lock the respective parts in their adjustedposition.

In operation, the patient lies with his head on the member 8T and hisback is supported by the plate 86. The extremity supporting member 26 isthen moved to the correct adjusted position l to support the fracturedmember.

It will be appreciated that I have provided a fracture frame wherein theextremity supporting member and the patient support means are suspendedfrom the frame thus obviating the necessity of lifting the patient fromthe stretcher onto the operating table. Furthermore, by suspending thepatient in this manner it affords a large area below the patient toenable much more satisfactory X-ray or iiuoroscopic examination of theinjured parts and greater facility for afxing casts or other boneretaining appliances. The extremity supporting members are mounted forangular, longitudinal and vertical adjustment, making it possible to usethe frame for all types of fractures.

In addition, the upright support members are provided with means wherebya hammock may be suspended therebetween. Further means are provided tochange the arc of the hammock to take care of any type of back injurywhich may have been sustained by the patient.

rIhere is also associated With the perineal bar a gallows likewise forthe treatment of patients with broken or injured backs.

rI'he frame is very mobile and can be cheaply and easily manufactured.The operation of the machine is relatively simple and does notnecessarily require the services of a skilled surgeon.

While I have shown and described the preferred embodiment of myinvention, I wish it to be understood that I do not confine myself tothe precise details of constructions herein set forth by way ofillustration, as it is apparent that many Changes and variations may bemade therein, by

those skilled in. the art. Without departing from the. spirit 0f theinvention. or exceeding the scope of the appended claims. v

I claim:

1. A fracture frame comprising upright menibers, horizontal membersconnected to the upper end of said upright members, a perineal barmounted for vertical movement with respect to the horizontal members, asacral seat attached to the lower end of the perineal bar, means to movethe perineal bar vertically to adjust the position of the seat withrespect to the horizontal members, and a rigid body support having oneend removably attached to the sacral seat and the other end secured tothe upright members.

2. A fracture frame comprising upright members, horizontal membersconnected to the upper endsy of the upright members, a perineal barmounted for vertical movement with respect to the horizontal members, asacral seat attached to the lower end of the perineal bar, a bracketadapted to be removably axed to said upright members, and a rigid bodysupport having one end attached to said bracket and the other endsecured to the sacral seat.

3. A fracture frame comprising upright members, horizontal membersconnected to the upper ends of said upright members, a sacral seatsuspended from the horizontal members, extremity supporting members, andmeans to suspend said extremity supporting members from the horizontalmembers.

4. A. fracture frame comprising upright members, horizontal membersconnected to the upper ends of said upright members, a sacral seatsuspended from the horizontal members and movable in relation thereto,extremity supporting members suspended from said horizontal members, andmeans to adjust the position of said extremity supporting membersrelative to the sacral seat. y

5,. A fracture frame comprising upright members, horizontal membersconnected to the upper ends of said upright members, a sacral seatsuspended from the horizontal members, extremity supporting members,supporting means for the extremity supporting members pivotally attachedto the horizontal members, said extremity supporting members beingmounted for universal movement on said supporting means, and furthermeans to adjust the supporting means longitudinally and vertically.

6. A fracture frame comprising upright members, horizontal membersconnected to the upper ends of the upright members, a sacral seatsuspended from the horizontal members and movable in relation thereto,extremity supporting members, supporting means for said extremitysupporting members suspended from said horizontal members, means toadjust the angular position of the supporting means in regard to thesacral seat, and further means to maintain said supporting means in itsadjusted position.

7. A fracture frame comprising upright members, horizontal membersconnected to the upper ends of said upright members, a sacral seatsuspended from said horizontal members, extremity supporting members,supporting means for said extremity supporting members suspended fromsaid horizontal members and capable of longitudinal and verticaladjustment, and means to maintain said supporting means in its adjustedposition.

,8. In a fracture frame of the type having upright members, horizontalmembers connected to the upper ends of said upright members, a perinealelement mounted for vertical movement with regard to the horizontalmembers, a sacral seat supported by the lower end of the perinealmember, means to move the perineal bar vertically, `and a gallowssupported by the upper end of the perineal member, the improvementcomprising an L-shaped bracket, the Vertical portion of which ts intothe upper ends of the perineal member, a pair of angularly disposedslots in the upper end of the perineal member and a pin on the verticalportion of the bracket for itting into either of said slots to maintainthe gallows in the proper position.

9. A fracture frame comprising upright members, horizontal membersconnected to the upper ends of said upright members, a sacral seatsupported by said horizontal members, extremity supporting members,supporting means for said extremity members suspended from saidhorizontal members, means to adjust the angular position of saidsupporting means, and a radius rod pivoted at one end to said horizontalmembersand at the opposite end to the supporting means to maintain saidsupporting means in its adjusted position.

10. A fracture frame comprising upright members, horizontal membersconnected to the upper ends of said upright members, a sacral seatsupported by said horizontal members, extremity supporting members,supporting means for said extremity supporting members suspended fromsaid horizontal members, means to adjust'the angular position of saidsupporting means, further means to adjust said supporting meanslongitudinally and vertically, and a radius rod pivoted at one end tothe horizontal members and at the opposite end to the supporting meansto maintain the supporting means in its angularly adjusted position.

HERBERT M. BERGAMINI.

